Heart failure & cardiomyopathiesCohort study
Risk of hypertension and heart failure linked to high-normal serum sodium and tonicity in general healthcare electronic medical records
- Retrospective cohort study
Authors' conclusion
A serum sodium and tonicity exceeding 140 mmol/L and 287 mosmol/kg are associated with increased risk of hypertension and heart failure in the general Israeli population.
Study context
- Population
- Adults (18–104 years) without significant chronic diseases or water balance issues, with normal serum sodium (135–146 mmol/L), 20-year EMRs of Israel's Leumit Healthcare Services
- Participants
- 407,187 adults
- Exposure
- Higher vs lower normal serum sodium and tonicity
- Outcome
- Incident hypertension and HF
Main finding
As reported in the abstract
Incident hypertension and HF by serum sodium and tonicity
Hazard ratio (95% CI)
serum sodium levels above 143 mmol/Lhypertension
1.29(1.25–1.33)
Tonicity over 287 mosmol/kghypertension
1.19(1.17–1.22)
sodium above 143 mmol/Lheart failure
1.20(1.12–1.29)
tonicity above 289 mosmol/kgheart failure
1.16(1.08–1.21)
- Hypertension risk rise at serum sodium 140-142 mmol/L
- 13%
Observational data: associations, not effects.
Further findings
Distribution of serum sodium among current healthy Leumit members
- Serum sodium 143-146 mmol/L
- 19%
- Serum sodium 140-142 mmol/L
- 39%
Original publication
Risk of hypertension and heart failure linked to high-normal serum sodium and tonicity in general healthcare electronic medical records. Eur J Prev Cardiol. Published 11 April 2025. doi:10.1093/eurjpc/zwaf232
Summarised from the published abstract; every number is checked against it